Bike riding and fluid intake

Hi all,

Just a few questions if possible. I had a pacemaker implanted about six months ago and all was going very well and back exercising about 5 days per week on the bike. However about four weeks ago I had a number of fainting spells and one severe episode of unconsciousness without any recollection leading up to the incident. Since then I have had the pacemaker readjusted and undertaken a number of follow up tests. it would now seem that I have vasovagal syncope. I undertook a test last Friday called the tilt table test and only lasted just over 19 minutes of the planned 45 minute test before losing consciousness. My Cardiologist informed me that this just about confirms vasovagal syncope and more importantly he is now pressuring me to give up just about all forms of exercise. The reason he gives is that I need to maintain a high fluid intake and this is unlikely because of exercise. I was wondering if anybody else out there has similar experience or able to offer me any constructive advise. I am experimenting with hydration tablets but not really sure if they can or will make a difference. I am currently riding about 250 kilometres per week.

Hoping everyone else is doing good and I really appreciate all the information which is availible in this club


Paul

4 Comments

hydration

by Tracey_E - 2010-04-26 08:04:26

I'm not sure what a hydration tablet is but there's no substitute for water. I use a camelback when I hike or bike.
http://www.camelbak.com/en/sports-recreation/hydration-packs.aspx

A habit I started when I was pregnant and had trouble staying hydrated that's stuck with me is to keep a large glass of water with me at all times. I have a big thermal cup (stays cold, doesn't sweat, has a lid and straw) that I fill with ice then add water as it gets low. I sip at it regularly and take it with me if I'm going to be out and about for more than a short trip. Having it handy means I'll keep working on it. I've done it so long now that I feel parched if I leave home without it.

Have you had a second opinion? I'm no expert but I thought a pm was usually the fix for vvs. A pm can't prevent bp drops but it'll make sure your heart rate never drops. There are some other suggestions on Mayo's website
http://www.mayoclinic.com/health/vasovagal-syncope/DS00806/DSECTION=treatments-and-drugs

Good luck. I would not simply give up exercise without a fight!

Me Too

by richan - 2010-04-27 02:04:32

Hi Paul,
Yes, I agree with TraceyE and sam78. I also think you and I had pretty much the same thing happen.
Basically, the bottom falls out of our BP - and it is sudden without much (or any) warning.
My cardio did not discourage me from continuing my Masters Swimming. Both he and my pacemaker lady told me to hydrate lots and like TraceyE has suggested, eat something before exercising. So, before swim practice I manage to eat 2 or 3 bananas and I start drinking my electrolytes which I continue to drink during and after swim practice. I'm finding that I pee a lot and wonder how much of the fluid am I absorbing.
I haven't done the hydration tablet thing - doesn't sound like much fun. Like sam78, my cardio has suggested that I increase my salt intake - it IS kinda funny, considering what the health people say about salt. My cardio also said that some people's physiology is such that it "throws off" sodium like mad. We may be part of that group.
Since my collapse I have been taking (like sam78) midodrine which is supposed to help prevent the bottom from falling out of my BP.
I would hope that you could continue your bike riding - it sounds like it may contribute to your mental health as well as your physical health, I'm thinking that you might be one of those hyper-athletes - which I am not. However, I do push myself to try keeping up with the others at swim practice (for my mental health).
So far, I have not collapsed but have had an occasional light-headed brown out which I have been able to handle. Although, I don't like getting them. This dizzy light headed stuff seems to be pretty common among pacemaker people. I'm not sure that there is a complete solution. I think the hardest part for me is keeping up with the hydration - don't know how you do it TraceyE.
Hang in there Paul!

richan

PS: Wasn't that tilt table thing something else?!!

i get it

by sam78 - 2010-04-27 12:04:15

I know what you mean, "hydration tablets". Salt tablets. Tracey is right.. a pacemaker will prevent the heart rate drop... however you can still have the blood pressure drop which is what you have. I had (have-but hate to admit it) that problem as well. There are a couple medications out there to help with this condition... typically they have you try salt tablets (hydration tablets as you called them).. Then there are medications such as florinef or midodrine. I tried all three. I initially took the salt tablets but was having to take so many it was making me sick. Second I tried Florinef. Just to mention that drug gives me shivers. I had a one in 300,000 reaction to the drug and ended up producing too much fluid in my brain (NOT good). Finally I tried midodrine. I have been on midodrine for about 3 years. I personally have found it effective. Even once I got my pacemaker I still took it. It wasnt until recently that we just couldnt regulate my blood pressure that we stopped it. The whole point in the medications and/or the hydration tablets is to give you a higher filling pressure in your heart. That makes it so if you do have a vasovagal episode that your filling pressure is higher so you dont pass out. I too would agree that giving up exercise is not the answer. You may have to limit your exercise but I would guess with the right medication and the increased intake of fluid with exercise would significantly help this. Again you might have to limit your exercise but I would some of the above first. I will say though.. it is funny to try and explain to someone why you are on a HIGH salt diet!! In case you didnt know.. increased salt makes you retain fluid. Hope that helps.

From another cyclist

by COBradyBunch - 2010-04-29 06:04:51

Had my pacemaker put in because of fainting spells that actually turned out to be heart naps (would stop completely for several seconds at a time, always restarted itself or else i wouldn't be writing this). Once they id'ed this and popped the pacer in my doc told me that I could also have vasovagal but a tilt table would be a waste of time and energy since my pacer should keep me from passing out (although not from sometimes feeling woozy, but have not had another syncope episode in 10 months). He also NEVER told me to stop exercising and actually recommended the opposite, that getting back in shape was a GOOD thing (I wasn't that bad, but not nearly as good as I used to be).

So you might have something else going on if your doc is saying stop all activity. I would double check since I have been in contact with a lot of folks who have been diaged with vasovagal and you are the first with a pacer who has been told to stop exercising.

You might also want to ask if they have found you to be chronically dehydrated. With cycling it is very easy to keep hydrated even on long rides (I often ride 50 miles or more and go out for 3-5 hour rides) by making sure you have two full water bottles (sport drinks in them also helps), you drink every chance you get and if you don't want to hassle with water bottles as someone else noted Camelbacks or other hyrdration systems are great alternatives. On longer rides you can usually find places to fill up on water/sports drinks along the way if necessary.

Most of all just keep hydrated. Rule of thumb, the more yellow your pee, the more dehydrated you are. keep your pee clear and light and you are likely doing fine.

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